Clinical manifestations of scabies

The first clinical manifestation of scabies is severe itching of the skin, particularly at night. The characteristic raised red pimples on the skin that develop later are due to an allergic response to the mites. You may also be able to see the threadlike burrows in the skin made by egg-laying female mites. In infants, the palms, soles, face and scalp are most often affected (figure a, below). In older children and adults the rash is most often found in the spaces between fingers and toes, wrist (figure b, below), armpits, ankles, navel, 'belt line', groin, buttocks, genitals in men and breasts in women.